Hidden Gems: Meet David Karli of Karli Center

His observation was lighthearted, but spot on. He wasn’t successful for no reason.

Platelet Rich Plasma (or PRP) was very new to the scene. An experimental treatment which concentrated platelets from a patient’s own the blood, injected to treat common Orthopedic problems like arthritis. Platelets coordinate healing in our body. The problems I had been trained to treat with medications, steroid injections and physical therapy. were frustrating me for years, reducing symptoms short term at best, but not solving the problems. I could park steroid anywhere in the body that I wanted with extreme precision using Xray or ultrasound guidance, only to see the patient back a few months later with the same pain. The common thread for most orthopedic problems was that the tissues all had a lousy blood supply, so they had little to no capacity to heal themselves and that’s why they become chronic sources of pain with age and after injury.

PRP made more sense to me. Delivering the body’s healing tools to places that they couldn’t get to normally, in an effort to stimulate healing, reduce inflammation and pain naturally, and keep it that way was logical. I had treated my own knee tendon with PRP – suffering for many years with intense pain – right at the bottom of my kneecap. After trial and error – PRP was the only thing that allowed me to solve the problem.

General trends for early success were good, but I had another problem to address: Physicians couldn’t measure all of the platelets and different cells in PRP. It relied on too much art and too little science, and a healthy skepticism from the medical community resulted. Just as injecting dangerous steroids didn’t make sense, not knowing exactly what “dose” of PRP I was injecting also didn’t make sense. Without measurement, I couldn’t learn why it worked or how to make it better!

This curiosity with PRP and cellular “dose” has led me all over the world, lecturing, writing, developing and researching ways to use a patient’s own cells (including their stem cells), to alleviate pain from joints, tendons and ligaments. Afflictions which cause millions to suffer, lose their livelihood and their health. It led to an MBA and to the formation of a biotech company (Greyledge Technologies), which I founded in 2010 to research how to make the body help itself, using the precise and rapid measurement of billions of cells, imported into a database to study exactly what doses and combinations work best for different patients and different clinical problems – a customized cell therapy approach.

After 20 years of practice in Vail, at 51 years of age, I moved my practice and biotech company to Miami after our practice was acquired by Private Equity. I had taken these concepts a long way, but to get to the next level, I couldn’t remain under the limitations of group thinking and the politics that come with it. My wife and I had been coming to Miami to escape Winter for several years and loved the lifestyle, culture, weather and the location was perfect for the majority of my patients, who fly to see me.

We designed our first location in North Coconut Grove from scratch to create the best patient experience and clinical resources to deliver cell therapies the way I felt they should be provided. Our Greyledge processing laboratory would be at the center of it, our data team would be overseeing a purpose: to learn from every patient that we see, by using AI to compare every cell type delivered into an injury to determine which cells and doses optimally predicted success, so we could give patients the best chance for a return on their investment.

As we grow, the intent is to add additional elements: a research lab and team to match our PhD efforts in Europe, initiating the study of genomics (our DNA and gene expression) or the unique genetic fingerprint of each patient to further improve how to best use healing cells to drive healing and regeneration in damaged tissues. We would add integrative providers to expand from targeting specific Ortho problems, to coordinating more general health from the simple perspective of “look great, feel great, perform great.” That would involve important health pillars: fitness, nutrition, hormone optimization and supplementation, modernizing resources for patients in each, collecting data in all.

We all face challenges, but looking back would you describe it as a relatively smooth road?
Disrupting commonalities of “how we do things” will always be difficult and met with conflict to change. Cell therapies remain controversial for good reason and bad. Sexy new biotechnologies always generate a “buzz” with celebrities and pro athletes seeking out the latest and greatest to maintain an edge in their professions. Early on, I found myself in the Wall Street Journal, TV, magazines and interviews suggesting that simple PRP was positioned to be the next great medical innovation. Unlike most medtech however, which peaks and dies as the scientific rigors of validating new therapies make it clear that they are not a great as initially touted, the cell and biologic therapies frenzy peaked and settled, but instead of falling off, the discipline has shown steady growth, more suggestive of a sustainability curve.

That was the green light to push harder in solidifying that the approach had legs and was worth the efforts of transitioning from art to scientific validation, which is what Greyledge Technologies was created to do. By thinking in terms of cellular “dose,” we can not only validate that treatments like PRP or progenitor (stem) cell product obtained from a patient’s own bone marrow or fat tissue are consistently effective, but set the stage as we learn to be able to accurately predict performance to position the treatments of Insurance and payor approvals globally.

Unfortunately, in a field driven by the desperation of pain, disability and loss of livelihood, there remains enormous potential for misuse and false promises catering to hope. This has allowed the field to grow for as many wrong reasons aside from the enormous potential that these therapies carry. As cash-based treatments, there is lots of money to be made and this will draw providers to cell therapies for the wrong reason.

Cell behavior is NOT governed by random events. There is order – a cause and effect relationship between application and clinical response. That cause and effect is complex, but measurable. To give the field a solid future to help a vast amount of people, it must be governed by standards, based in procedure, science, data and quality control. My goal has always been to define that standard and responsibly (but innovatively) guide development to a good place.

My approach however, is the more difficult road. It’s easy to use cell therapies poorly, so my call to action for clinicians, industry and scientists to be better has (as would be expected) been met with conflict, passive aggression and at times bad behavior targeting me and Greyledge. I had to watch companies that were willing to cut corners, not play by the rules of the FDA and make promises without evidence to support, move way faster than we could.

The silver lining however, is that Physician culture over many years is changing. Instead of me sending challenging messages from podiums at Academic Conferences, little by little, I started to hear my peers deliver messages that we need measurement, quality control, data-backed best practices. It was a lonely and thankless road at times, and I’ll never get credit for driving the field in this way, but there is a personal satisfaction that the difficult parts of the journey helped to create a better future scientifically, clinically and most importantly for the end consumer – the patients who will benefit from this exciting field. Hopefully with this cultural change, Greyledge will be positioned to thrive in its ongoing research and development efforts.

Thanks for sharing that. So, maybe next you can tell us a bit more about your business?
Karli Center is my medical practice and the headquarters for Greyledge Technologies, the biotech company I founded in 2010 to research and develop cellular therapies derived from a patient’s own body. KC is the embodiment of 20+ years of work, patient care and meticulous tech development, housed under one roof.

Our initial offering to patients, maintained a focus on nonsurgical treatment of Orthopedic problems, like arthritis/joint pain, tendon or ligament injuries, back pain and the disability that results from them. Somewhat faster than anticipated, KC is expanding applications of cell therapies towards cosmetic applications and sexual dysfunction as well as the integration of hormone optimization, medical fitness and genomics medicine, consistent with the overall mission to help our patient clients “look great, feel great and perform great.”

We integrate our emphasis on data collection across all of these disciplines – looking to understand how best to coordinate patient care to enhance what I call “performance healthcare.” Human performance isn’t limited to professional athletes! Principles of sports and functional medicine, along with our expertise in cell therapies applies to everyone with the common goal of improving quality of life and our functional longevity. This means not only living longer, but living longer while maintaining an active life!

Central and unique to our practice is our data cloud. We collect lots and lots of data on every patient, from cellular data to genomics, to treatment outcomes – all contained within this custom cloud. From it our data team coordinates with AI platforms to continually learn and identify trends that we can use to continually apply to make our treatment precise, accurate, safe and effective. We also place great emphasis on the patient experience with a focus on customer service, patient comfort and efficiencies of working together with our great and growing team.

We see patients from all over the world, but are newer to the Miami market, which I’m proud to now call home. We hope to continue to expand a world class center of excellence as a resource to our community, but also to draw patients from all over the globe to Miami and all that it has to offer.

We’d love to hear about how you think about risk taking?
Risk is an absolute necessity, but with one spin. When dealing with patient lives, we must walk the line of cutting edge innovation, but not violate the Hippocratic premise of ” Primum non nocere” or “First do no harm.”

We work under an active microscope driven by multiple parties with a keen interest on seeing us succeed or hoping we fail. The risk from this exposure forces us to execute tightly, perform to our principles and expectations, without exception and to embrace the exposure to drive our best.

My risk exists on many levels. As the face of both our biotech development company and the Karli Center – I’m on the line to make good on solutions that patients, investors and the media want and expect. I have a healthy comfort with risk, but also respect and have followed an important guiding premise: “The more we mess with nature, the greater the chance that it will bite us back!”

A general premise is that the measure of success is consistent with the size of the problem you solve. Our technology has the potential to positively disrupt billion dollar medical sectors. The risk is that these parties don’t necessarily want to be disrupted! We could fail at any moment, risk career embarrassment continually, but I’ve always considered it work worth doing, so the risk sets up the reward accordingly.